[Steristripqueen]

Hello everyone. I have been lurking on this forum and you all have some wonderful replies so I thought I would put this question out there.

I have worked for 17 yrs in corrections and once again people who are not medical are constantly telling the nurses what to do. I actually had a Sgt., Lt., Capt and Dep. give me a direct order to check a inmates genitals! Of course it was a Sun and no other nurses or Dr. around. I am just wondering how do you keep a decent attitude? Oh and they want my job because of this. V/S were stable, urine dipstick all WNL, clothing not punctured/torn/shredded, no blood visible on clothing. I/M initally claimed bleeding from penis then changed his mind and decided on having the flu. I am at the end of my rope and don't want to have a bad attitude BUT.... well thanks for reading my rant.

[VegRN]

Why did the keystone cops want you to check the inmates penis? What did they think was going on?

If the inmate changed his mind then you have no reason to check it. If he is denying urinary symptoms then checking his penis would violate the inmates rights, no?

If the officer is bossy and rude, I usually just ignore them when they offer medical advice. I say something like "hmmm" like I am actually thinking about it and then go on with my day, with assessing the i/m and so on. If the officer is actually trying to be helpful then I usually explain the rationale later as to why I am not going to assess this or that.

The officers ("honorary RN" or so they think) sometimes have funny ideas as to what they would do though. I usually giggle about it later with my coworkers.

[Steristripqueen]

Thank you for replying but it is just so fraustrating to have your boss (the Dep) who is not a Dr or nurse give a direct order and jepordize the i/m and me! I have a meeting with him and the union soon can't wait to hear his explanation. Anyways thank you for responding and reading my vent. Means a lot!

[Blackcat99]

When I worked in corrections I had a resident who complained of back pain. That inmate was a "known manipulator". I called my boss and told her that the officers were calling me on the phone every 15 minutes demanding that I send this resident to the ER. My boss told me "absolutely not" I told the officers that my boss said to just bring him here to the infirmary and the doctor would see him the next day. The officers said No, they were not going to bring him to the infirmary because he needed to go straight to the ER. I told them OK, I will call my boss and let her know that the officers are refusing her direct order to bring him to the infirmary. After thinking it over for 15 minutes, the officers brought him to the infirmary. They continued to call me every 30 minutes that night.They were extremely hostile to me and were still demanding that I send him to the ER. Of course, when our prison doctor (who knows this inmate well arrived the next day), the inmate suddenly had a "miraculous recovery" had no back pain and went right back to his regular cell.

[cid2008]

Security medicine is so very common...but my view point is...see the offender as a pt., not an offender ...we so often see them only as I/m's and this is beginning to become a problem in the state of Texas. Many nurses are loosing their license secondary to neglect. I try to remeber that these men have abused their bodies severely before arriving here...some of them are really very sick...too many times they are sent to their cell with nothing but a non aspirin and a cussing. If security can present me with a reason for their concern, such as the pt. being extorted in some way, like sexually...then it gives me grounds to question him as to maybe him being forced to participate in sexual favors or such, and also due to security reasons maybe check him for self inflicted injury...on our unit, we have several EMT's and they frequently try to run the medical end of things, usually my reply is, "And you got your degree where?" That usually takes care of it. I try not to make anyone angry...but you have to hold your ground. Example of officer saying during inservice that he thought that most of the offenders that threaten to beat someones face off are usually bluffing and just working the system...I spoke up and said, "since you want to do the diagnosing...next time we will send you to see if he means what he says." Now that officer sends the I/M for medical to assess.

[cid2008]

just another tidbit...Sometimes I say to the officer...your job is security and mine is medicine...why don't we attempt to take care of our specific jobs. If you feel there is a security issue involved here please inform me and we will go from there. At any time did you question why they were so adimate about sending this offender to the E.R.? I know that they are clamping down on security just like they are us about neglect. In Texas, the law now has it where security can serve time for not acting appropriately concerning the safety and care of the I/M...Safe Prisons and ACA have some pretty rigid guide lines.

[afteralltheseyears]

One thing that I have done on occasion that seems to work fairly well to prevent a situation such as this from happening again (from this staff member anyway) is to document what happened in a staff report or incident report (whatever you call them where you are). Reporting in a formal document when something was not done according to protocol or that was done out of that security person's "scope of practice" may lead to that staff member's supervisor having to address it. Where I'm located each staff report has to have a response or resolution to a problem documented by a manager.